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Meta-Analysis
. 2015 Dec 14;10(12):e0144319.
doi: 10.1371/journal.pone.0144319. eCollection 2015.

Association between Herpesviruses and Chronic Periodontitis: A Meta-Analysis Based on Case-Control Studies

Ce Zhu  1 , Fei Li  1 , May Chun Mei Wong  2 , Xi-Ping Feng  1 , Hai-Xia Lu  1 , Wei Xu  3
Affiliations
Meta-Analysis

Association between Herpesviruses and Chronic Periodontitis: A Meta-Analysis Based on Case-Control Studies

Ce Zhu et al. PLoS One. .

Abstract

Objective: Numerous studies have investigated the associations between herpesviruses and chronic periodontitis; however, the results remain controversial. To derive a more precise estimation, a meta-analysis on all available studies was performed to identify the association between herpesviruses and chronic periodontitis.

Methods: A computerized literature search was conducted in December 2014 to identify eligible case-control studies from the PUBMED and EMBASE databases according to inclusion and exclusion criteria. Data were extracted and pooled odds ratios (OR) with 95% confidence intervals (CI) were used to assess the association between herpesviruses and risk of chronic periodontitis. A fixed or random effects model was determined based on a heterogeneity test. Sensitivity analysis was conducted to investigate stability and reliability. Publication bias was investigated using the Begg rank correlation test and Egger's funnel plot.

Results: Ten eligible studies were included to investigate the association between Epstein-Barr virus (EBV) and chronic periodontitis. The results showed that EBV has a significant association with chronic periodontitis compared with periodontally healthy group (OR = 5.74, 95% CI = 2.53-13.00, P<0.001). The association between human cytomegalovirus (HCMV) and chronic periodontitis was analyzed in 10 studies. The pooled result showed that HCMV also has a significant association with chronic periodontitis (OR = 3.59, 95% CI = 1.41-9.16, P = 0.007). Similar results were found in the sensitivity analyses. No significant publication bias was observed. Two eligible studies were included to investigate the association between herpes simplex virus (HSV) and chronic periodontitis risk. The association between HSV and chronic periodontitis was inconclusive (OR = 2.81 95% CI = 0.95-8.27, P = 0.06). Only one included study investigated the association between human herpesvirus 7 (HHV-7) and chronic periodontitis risk (OR = 1.00, 95% CI = 0.21-4.86).

Conclusion: The findings of this meta-analysis suggest that two members of the herpesvirus family, EBV and HCMV, are significantly associated with chronic periodontitis. There is insufficient evidence to support associations between HSV, HHV-7 and chronic periodontitis.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart for the study selection process.
Fig 2
Fig 2. Forest plot of the association between herpesviruses and risk of chronic periodontitis (CP): (A) EBV and CP risk, (B) HCMV and CP risk, (C) HSV and CP risk.
Fig 3
Fig 3. Sensitivity analysis of the association between herpesviruses and risk of chronic periodontitis (CP): (A) EBV and CP risk, (B) HCMV and CP risk.
Fig 4
Fig 4. Egger’s funnel plot of the association between herpesviruses and risk of chronic periodontitis (CP): (A) EBV and CP risk, (B) HCMV and CP risk.
See this image and copyright information in PMC

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